TY - JOUR
T1 - Acute kidney injury in tropical acute febrile illness in a tertiary care centreRIFLE criteria validation
AU - Basu, Gopal
AU - Chrispal, Anugrah
AU - Boorugu, Harikishan
AU - Gopinath, Kango G.
AU - Chandy, Sara
AU - Prakash, John Anthony Jude
AU - Thomas, Kurien
AU - Abraham, Asha M.
AU - John, George T.
PY - 2011/2
Y1 - 2011/2
N2 - Background. Acute febrile illnesses are a common cause of tropical acute kidney injury (AKI). The incidence and severity of AKI in tropical febrile illnesses and validity of RIFLE classification are unclear.Methods. Consecutive adult inpatients of a tertiary hospital in southern India with tropical acute febrile illness between January 2007 and January 2008 were prospectively studied for the incidence and severity of AKI based on RIFLE classification and its association with mortality and dialysis requirement.Results. The 367 patients (mean age 39.7 ± 16.9 years; 60% males) with tropical acute febrile illness due to scrub typhus (51.2%), falciparum malaria (10.4%), enteric fever (8.7%), dengue (7.6%), mixed malaria (6.5%), leptospirosis (3.3%), undifferentiated acute febrile illness (8.4%) and others (3.8%) (spotted fever, vivax malaria and Hantaan virus infection) had an overall mortality rate of 12.3%. The incidence of AKI was 41.1%; of which, 17.4%, 9.3% and 14.4% were in the Risk, Injury and Failure classes, respectively. Of the patients, 7.9% required dialysis. Among the Risk, Injury and Failure groups, there was an incremental risk of mortality (OR 6.9, 20.2 and 25.6; P < 0.001) and dialysis requirement (OR 3.4, 28.8 and 178.8; P < 0.001).Conclusions. The incidence of AKI in the common tropical acute febrile illnesses in our study such as scrub typhus, falciparum malaria, enteric fever, dengue and leptospirosis is 41.1%. RIFLE classification is valid and applicable in AKI related to tropical acute febrile illnesses, with an incremental risk of mortality and dialysis requirement.
AB - Background. Acute febrile illnesses are a common cause of tropical acute kidney injury (AKI). The incidence and severity of AKI in tropical febrile illnesses and validity of RIFLE classification are unclear.Methods. Consecutive adult inpatients of a tertiary hospital in southern India with tropical acute febrile illness between January 2007 and January 2008 were prospectively studied for the incidence and severity of AKI based on RIFLE classification and its association with mortality and dialysis requirement.Results. The 367 patients (mean age 39.7 ± 16.9 years; 60% males) with tropical acute febrile illness due to scrub typhus (51.2%), falciparum malaria (10.4%), enteric fever (8.7%), dengue (7.6%), mixed malaria (6.5%), leptospirosis (3.3%), undifferentiated acute febrile illness (8.4%) and others (3.8%) (spotted fever, vivax malaria and Hantaan virus infection) had an overall mortality rate of 12.3%. The incidence of AKI was 41.1%; of which, 17.4%, 9.3% and 14.4% were in the Risk, Injury and Failure classes, respectively. Of the patients, 7.9% required dialysis. Among the Risk, Injury and Failure groups, there was an incremental risk of mortality (OR 6.9, 20.2 and 25.6; P < 0.001) and dialysis requirement (OR 3.4, 28.8 and 178.8; P < 0.001).Conclusions. The incidence of AKI in the common tropical acute febrile illnesses in our study such as scrub typhus, falciparum malaria, enteric fever, dengue and leptospirosis is 41.1%. RIFLE classification is valid and applicable in AKI related to tropical acute febrile illnesses, with an incremental risk of mortality and dialysis requirement.
KW - acute kidney injury/acute renal failure
KW - dengue
KW - malaria
KW - RIFLE
KW - scrub typhus
UR - http://www.scopus.com/inward/record.url?scp=79551486674&partnerID=8YFLogxK
U2 - 10.1093/ndt/gfq477
DO - 10.1093/ndt/gfq477
M3 - Article
C2 - 20702532
AN - SCOPUS:79551486674
VL - 26
SP - 524
EP - 531
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
IS - 2
ER -